California Democratic Senator Diane Feinstein returned to the Capitol last week after spending more than two months recovering from shingles. The disease, often characterized by painful rashes, is caused by the same virus that causes chickenpox, stays in the body for life, and can reactivate after a few years.
In Feinstein, 89, the virus also caused a previously unreported case of encephalitis. This is a rare but potentially debilitating complication of swelling of the brain. This condition is often caused by an infection or an immune response.
What are the symptoms of encephalitis?
Postherpetic encephalitis can cause headache, fever, photosensitivity, vomiting, confusion, stiff neck, and even seizures.
Also, some patients may have more persistent problems. These include memory and speech disorders, sleep disturbances, mood disorders, difficulty walking, and other cognitive impairments. Older patients tend to be the most difficult to recover from.
There are milder cases and more severe cases.a learning french since last year A study of dozens of critically ill patients with the disease found that about one-fifth were severely disabled and one-third died within a year of hospitalization.
a Independent study in Denmark from 2020 They found that about half of patients with postherpetic encephalitis admitted to hospital had at least moderate disability three months after discharge.
How common is this condition?
Dr. Adrien Milous, a physician and immunologist based at the Sorbonne University in Paris, who led a study in France last year, estimates that less than 1 percent of people with shingles develop encephalitis.
But it’s hard to pinpoint an exact incidence, he said. Mild cases are often unreported, making it difficult to know the true number of people with herpes zoster and postherpetic encephalitis.
Brain swelling has historically been thought to primarily affect immunocompromised shingles patients. However, recent studies have found that many patients are simply elderly and suffer from the daily weakening of their immune systems. As such, the condition could become more common as the population ages, experts say.
What is the outlook for patients?
It is not entirely clear why some people with shingles who develop encephalitis get better or worse. Older people seem to be at greater risk of developing more serious problems.
However, published case studies also report young patients whose cognitive function only worsens again after showing signs of recovery.
Dr. Mirows said of patients, “Sometimes symptoms persist after encephalitis.” “I don’t know if I’ll ever fully recover. It’s the same at 89, it’s the same at 30, 20.”
Feinstein may have been at higher risk of developing encephalitis because her shingles had spread to her face and neck, which is known to put patients at risk for brain inflammation.
What other effects does shingles have on people’s cognition?
Inflammation alone can damage brain cells.
But shingles may also contribute to cognitive decline in other ways, such as cerebrovascular damage, says an internist and epidemiologist at Brigham and Women’s Hospital and Harvard Medical School, who has linked herpes zoster with shingles. Dr. Sharon E. Curhan, who studies sex, said: and cognitive changes.
People with shingles also have a significantly higher long-term risk of having a stroke, and the stroke itself can cause cognitive decline, according to one researcher. Research Led by Dr. Kahan Published last year.
Feinstein said received the shingles vaccineThis gives most people strong protection against the virus and its complications.federal health officials recommend a vaccine For people over 50 and young people with weakened immune systems.
